Annual Report
For the Period Ended
September 30, 2023
First Trust Exchange-Traded Fund II
Book 2
First Trust Nasdaq Lux Digital Health Solutions ETF (EKG)
First Trust Indxx Metaverse ETF (ARVR)
First Trust Bloomberg Emerging Market Democracies ETF
(EMDM)

Table of Contents
First Trust Exchange-Traded Fund II
Annual Report
September 30, 2023
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3
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41
43

Caution Regarding Forward-Looking Statements
This report contains certain forward-looking statements within the meaning of the Securities Act of 1933, as amended, and the Securities Exchange Act of 1934, as amended. Forward-looking statements include statements regarding the goals, beliefs, plans or current expectations of First Trust Advisors L.P. (“First Trust” or the “Advisor”) and its representatives, taking into account the information currently available to them. Forward-looking statements include all statements that do not relate solely to current or historical fact. For example, forward-looking statements include the use of words such as “anticipate,” “estimate,” “intend,” “expect,” “believe,” “plan,” “may,” “should,” “would” or other words that convey uncertainty of future events or outcomes.
Forward-looking statements involve known and unknown risks, uncertainties and other factors that may cause the actual results, performance or achievements of any series of First Trust Exchange-Traded Fund II (the “Trust”) described in this report (each such series is referred to as a “Fund” and collectively, as the “Funds”) to be materially different from any future results, performance or achievements expressed or implied by the forward-looking statements. When evaluating the information included in this report, you are cautioned not to place undue reliance on these forward-looking statements, which reflect the judgment of the Advisor and its representatives only as of the date hereof. We undertake no obligation to publicly revise or update these forward-looking statements to reflect events and circumstances that arise after the date hereof.
Performance and Risk Disclosure
There is no assurance that any Fund described in this report will achieve its investment objective. Each Fund is subject to market risk, which is the possibility that the market values of securities owned by the Fund will decline and that the value of the Fund’s shares may therefore be less than what you paid for them. Accordingly, you can lose money by investing in a Fund. See “Risk Considerations” in the Additional Information section of this report for a discussion of certain other risks of investing in the Funds.
Performance data quoted represents past performance, which is no guarantee of future results, and current performance may be lower or higher than the figures shown. For the most recent month-end performance figures, please visit www.ftportfolios.com or speak with your financial advisor. Investment returns, net asset value and share price will fluctuate and Fund shares, when sold, may be worth more or less than their original cost.
The Advisor may also periodically provide additional information on Fund performance on each Fund’s webpage at www.ftportfolios.com.
How to Read This Report
This report contains information that may help you evaluate your investment. It includes details about each Fund and presents data and analysis that provide insight into each Fund’s performance and investment approach.
By reading the market overview by Robert F. Carey, Chief Market Strategist of the Advisor, you may obtain an understanding of how the market environment affected the performance of each Fund. The statistical information that follows may help you understand each Fund’s performance compared to that of relevant market benchmarks.
It is important to keep in mind that the opinions expressed by personnel of the Advisor are just that:informed opinions. They should not be considered to be promises or advice. The opinions, like the statistics, cover the period through the date on the cover of this report. The material risks of investing in each Fund are spelled out in its prospectus, statement of additional information, and other Fund regulatory filings.
Page 1

Shareholder Letter
First Trust Exchange-Traded Fund II
Annual Letter from the Chairman and CEO
September 30, 2023
Dear Shareholders,
First Trust is pleased to provide you with the annual report for certain series of the First Trust Exchange-Traded Fund II (the “Funds”), which contains detailed information about the Funds for the twelve months ended September 30, 2023. Please note that the First Trust Bloomberg Emerging Market Democracies ETF (EMDM) was incepted on March 2, 2023, so information in this letter and the report prior to that date will not apply to that Fund. 
A famous financial industry quote came to mind as I was sizing up the current business climate:“Wall Street has a few prudent principles; the trouble is that they are always forgotten when they are most needed.” The past year has been a time when those who stuck with their principles were rewarded, in my opinion. The financial markets continue to battle a myriad of headwinds, from geopolitical uncertainty resulting from war (Israel and Hamas and the conflict between Russia and Ukraine), to slowing global economic growth and inflation. Inflation, for one, has remained persistently high. A common measure of inflation is the 12-month rate of change in the Consumer Price Index (“CPI”). The CPI stood at 3.7% on September 30, 2023, significantly lower than its most recent high of 9.1% set on June 30, 2022, but up from its most recent low of 3.0% on June 30, 2023. Considering this, as well as other better-than-expected economic data, the Federal Reserve recently noted that the Federal Funds target rate will need to remain elevated for a longer period than previously expected.
As many investors are likely aware, a higher Federal Funds target rate has deep implications for consumers. Perhaps the most obvious area impacted by higher rates is housing. The national average for a 30-year mortgage stood at 7.99% as of October 18, 2023, up from 3.22% on October 20, 2021. Higher mortgage rates, coupled with high home prices, are stretching U.S. home affordability. The monthly payment on a median-priced home ($407,100 in August 2023) with a 20% down payment, and a mortgage rate of 7.99%, comes in at $2,387. It is not just mortgage rates that are pressuring the budgets of U.S. households. Debt payments on car loans and credit cards are showing signs of weakness as well. Data from the Federal Reserve Bank of New York revealed that the rate of new credit card and new auto loan delinquencies stood at 7.2% and 7.3%, respectively, in the second quarter of 2023 (most recent data), surpassing pre-pandemic levels.
While headwinds to the global economy exist, not all the news is bad. Driven by technological developments in artificial intelligence, the U.S. equity markets have had a phenomenal year. Year-to-date through September 30, 2023, the S&P 500® Index has enjoyed a total return of 13.07%. Additionally, the U.S. exported a record 20.4 billion cubic feet per day (“Bcf/d”) of natural gas and 11.6 Bcf/d of liquefied natural gas (“LNG”) over the first six months of the year, making the U.S. the world’s largest exporter of LNG during this period. It can be tempting to deviate from fundamentals when times get tough, but we continue to encourage investors to hold fast to their principles; they will serve you for years to come.
Thank you for giving First Trust the opportunity to play a role in your financial future. We value our relationship with you and will report on the Funds again in six months.
Sincerely,
James A. Bowen
Chairman of the Board of Trustees
Chief Executive Officer of First Trust Advisors L.P.
Page 2

Market Overview
First Trust Exchange-Traded Fund II
Annual Report
September 30, 2023 
Robert F. Carey, CFA
Senior Vice President and Chief Market Strategist
First Trust Advisors L.P.
Mr. Carey is responsible for the overall management of research and analysis of the First Trust product line. Mr. Carey has more than 30 years of experience as an Equity and Fixed-Income Analyst and is a recipient of the Chartered Financial Analyst (“CFA”) designation. He is a graduate of the University of Illinois at Champaign-Urbana with a B.S. in Physics. He is also a member of the Investment Analysts Society of Chicago and the CFA Institute. Mr. Carey has appeared as a guest on such programs as Bloomberg TV, CNBC, and WBBM Radio, and has been quoted by several publications, including The Wall Street Journal, The Wall Street Reporter, Bloomberg News Service and Registered Rep.
State of the Global Economy
The latest global growth forecast from the International Monetary Fund (“IMF”) released in October 2023 sees real gross domestic product growth rising by 3.0% worldwide in 2023, up from its 2.9% projection in January 2023. The IMF is currently forecasting a 2.1% growth rate for the U.S., up from its January 2023 estimate of 1.4%. Emerging Market and Developing Economies are expected to grow by 4.0% this year, unchanged from the IMF’s 4.0% estimate in January 2023. The IMF notes that risks to their global outlook remain tilted to the downside, citing the real estate crisis in China, the potential for increased volatility among commodity prices, and uncomfortably high inflation, among other reasons, for their outlook.
In the U.S., inflation, as measured by the Consumer Price Index (“CPI”), stood at 3.7% on a trailing 12-month basis at the end of September 2023, according to the U.S. Bureau of Labor Statistics. While this is significantly lower than the most recent high of 9.1% in June 2022, the September 2023 CPI reading reflects a re-acceleration in the metric when compared to its most recent low of 3.0% set on June 30, 2023.
Performance of Global Stocks and Bonds
The major U.S. stock indices delivered positive results over the past 12 months. The S&P 500® (the “Index”), S&P MidCap 400® and S&P SmallCap 600® Indices posted total returns of 21.62%, 15.51% and 10.08%, respectively, for the 12-month period ended September 30, 2023. Nine of the 11 major sectors that comprise the Index were positive on a total return basis. The top performer was the Information Technology sector, up 41.10%, while the worst showing came from the Utilities sector, down 7.02%.
A Bloomberg survey of twenty-two equity strategists found that their average 2023 year-end price target for the Index was 4,370 as of October 18, 2023, according to its own release. The highest and lowest estimates were 4,900 and 3,700, respectively. The Index closed trading on September 29, 2023, at 4,288.05. Bloomberg’s consensus year-over-year earnings growth rate estimates for the Index for the 2023 and 2024 calendar years stood at -2.83% and 11.89%, respectively, as of October 13, 2023.
The broader foreign stock indices experienced positive total returns over the past year. For the 12-month period ended September 30, 2023, the MSCI World ex USA and MSCI Emerging Markets equity indices posted total returns of 24.00% (USD) and 11.70% (USD), respectively, according to Bloomberg. The major foreign bond indices were also up over the same period. The Bloomberg Global Aggregate Index of higher quality debt posted a total return of 2.24% (USD), while the Bloomberg EM Hard Currency Aggregate Index of emerging markets debt rose by 8.57% (USD), according to Bloomberg. The U.S. dollar fell 5.30% over the past 12 months against a basket of major currencies, as measured by the U.S. Dollar Index. The decrease in the dollar provided a boost to the performance of both foreign stock and bond indices, in our opinion.
Results were also positive in the U.S. bond market over the period. The top performing major debt group we track was intermediate U.S. high yield bonds. The Bloomberg Intermediate U.S. High Yield Index posted a total return of 10.34% for the 12-month period ended September 30, 2023. The worst performing U.S. debt group that we track was the Ginnie Mae 30-Year Bond. The Bloomberg Ginnie Mae 30-Year Index posted a total return of 0.29%. The yield on the benchmark 10-Year Treasury Note (“T-Note”) rose by 74 basis points in the period to close at 4.57% on September 29, 2023, according to Bloomberg. For comparative purposes, the average yield on the 10-Year T-Note was 2.27% for the 10-year period ended September 30, 2023.
Page 3

Fund Performance Overview (Unaudited)
First Trust Nasdaq Lux Digital Health Solutions ETF (EKG)
The First Trust Nasdaq Lux Digital Health Solutions ETF (the “Fund”) seeks investment results that correspond generally to the price and yield (before the Fund’s fees and expenses) of an equity index called the Nasdaq Lux Health TechTM Index (the “Index”). The shares of the Fund are listed and trade on Nasdaq, Inc. under the ticker symbol “EKG.” The Fund will normally invest at least 80% of its net assets (plus any borrowings for investment purposes) in the common stocks and depositary receipts that comprise the Index. The Index is developed, maintained and sponsored by Nasdaq, Inc. (the “Index Provider”). According to the Index Provider, the Index is designed to measure the performance of a selection of companies that are primarily engaged in and involved at the intersection of healthcare and technology, as classified by Lux Capital based on analysis of the products and services offered by those companies.
Performance
 
 
Average Annual
Total Returns
Cumulative
Total Returns
 
1 Year
Ended
9/30/23
Inception
(3/22/22)
to 9/30/23
Inception
(3/22/22)
to 9/30/23
Fund Performance
 
 
 
NAV
-0.56%
-21.63%
-31.07%
Market Price
-0.78%
-21.67%
-31.12%
Index Performance
 
 
 
Nasdaq Lux Health TechTM Index
0.12%
-21.14%
-30.40%
S&P Composite 1500® Health Care Index
7.38%
-2.93%
-4.44%
(See Notes to Fund Performance Overview on page 10.)
Performance Review
The Fund generated a net asset value (NAV) return of -0.56% during the 12-month period covered by this report. During the same period, the S&P Composite 1500® Health Care Index (the “Benchmark”) generated a return of 7.38%. The Health Care Equipment & Supplies industry received the greatest allocation in the Fund during the period covered by this report, with an average weight of 54.5%, and also had a contribution of 2.9% to the Fund’s return, the greatest of any industry. The Life Sciences Tools & Services industry, with an average weight of 23.4%, received the second greatest allocation within the Fund and was the most negatively contributing industry in the Fund with a contribution to return of -1.9%.

Nasdaq® and Nasdaq Lux Health TechTM Index are registered trademarks and service marks of Nasdaq, Inc. (together with its affiliates hereinafter referred to as the “Corporations”) and are licensed for use by First Trust. The Fund has not been passed on by the Corporations as to its legality or suitability. The Fund is not issued, endorsed, sold or promoted by the Corporations. THE CORPORATIONS MAKE NO WARRANTIES AND BEAR NO LIABILITY WITH RESPECT TO THE FUND.
Page 4

Fund Performance Overview (Unaudited) (Continued)
First Trust Nasdaq Lux Digital Health Solutions ETF (EKG) (Continued)
 
Sector Allocation
% of Total
Long-Term
Investments
Health Care
100.0%
Total
100.0%
Top Ten Holdings
% of Total
Long-Term
Investments
Veeva Systems, Inc., Class A
8.9%
Intuitive Surgical, Inc.
8.5
Dexcom, Inc.
8.5
IQVIA Holdings, Inc.
8.1
Align Technology, Inc.
7.5
Hologic, Inc.
4.2
ResMed, Inc.
4.2
QIAGEN N.V.
4.1
Insulet Corp.
3.8
Illumina, Inc.
3.8
Total
61.6%
Performance figures assume reinvestment of
all distributions and do not reflect the
deduction of taxes that a shareholder would
pay on Fund distributions or the redemption
or sale of Fund shares. An index is a statistical
composite that tracks a specified financial
market or sector. Unlike the Fund, the indices
do not actually hold a portfolio of securities
and therefore do not incur the expenses
incurred by the Fund. These expenses
negatively impact the performance of the
Fund. The Fund’s past performance does not
predict future performance.
Frequency Distribution of Discounts and Premiums
Information showing the number of days the market price of the Fund’s shares was greater (at a premium) and less (at a discount) than the Fund’s net asset value for the most recently completed year, and the most recently completed calendar quarters since that year (or life of the Fund, if shorter) is available at https://www.ftportfolios.com/Retail/etf/home.aspx.
Page 5

Fund Performance Overview (Unaudited) (Continued)
First Trust Indxx Metaverse ETF (ARVR)
The First Trust Indxx Metaverse ETF (the “Fund”) seeks investment results that correspond generally to the price and yield (before the Fund’s fees and expenses) of an equity index called the Indxx Metaverse Index (the “Index”). The shares of the Fund are listed and trade on Nasdaq, Inc. under the ticker symbol “ARVR.” Under normal market conditions, the Fund will invest at least 80% of its net assets (plus any borrowings for investment purposes) in the common stocks and depositary receipts that comprise the Index. The Index is developed, maintained and sponsored by Indxx, Inc. (the “Index Provider”). The Index Provider is not affiliated with the Fund, the Fund’s investment advisor or the Fund’s distributor. According to the Index Provider, the Index is a rules-based index, however, the Index Provider reserves the right to use qualitative judgment to include, exclude, adjust, or postpone the inclusion of a stock in the Index. “Metaverse” is a term used to describe the next generation of the Internet, which has the potential to allow creators to build the next chapter of human interaction through immersive experiences in three-dimensional virtual spaces. The Index is comprised of companies that provide services and products that support the infrastructure and applications of the Metaverse.
Performance
 
 
Average Annual
Total Returns
Cumulative
Total Returns
 
1 Year
Ended
9/30/23
Inception
(4/19/22)
to 9/30/23
Inception
(4/19/22)
to 9/30/23
Fund Performance
 
 
 
NAV
30.66%
-2.34%
-3.37%
Market Price
30.48%
-2.23%
-3.21%
Index Performance
 
 
 
Indxx Metaverse Index
31.64%
-1.49%
-2.16%
MSCI ACWI Index
20.80%
-1.93%
-2.78%
(See Notes to Fund Performance Overview on page 10.)
Performance Review
The Fund generated a NAV return of 30.66% during the 12-month period covered by this report. During the same period, the MSCI ACWI Index (the “Benchmark”) generated a return of 20.80%. Two sectors carried most of the weight in the Fund during the period. The Information Technology sector received an allocation of 55.8% and contributed 20.2% to the Fund’s return and the Communication Services sector received an allocation of 38.7% and contributed 8.9% to the Fund’s return. The only negatively contributing sector was the Health Care sector, in which the Fund held only one security. Teladoc Health, Inc. received a 1.2% allocation and created a -0.4% contribution to the Fund’s overall return. The Fund’s currency exposure had a 0.4% impact on performance during the period covered by this report.

Indxx and Indxx Metaverse Index (“Index”) are trademarks of Indxx, Inc. (“Indxx”) and have been licensed for use for certain purposes by First Trust. The Fund is not sponsored, endorsed, sold or promoted by Indxx and Indxx makes no representation regarding the advisability of trading in such product. The Index is determined, composed and calculated by Indxx without regard to First Trust or the Fund.
Page 6

Fund Performance Overview (Unaudited) (Continued)
First Trust Indxx Metaverse ETF (ARVR) (Continued)
 
Sector Allocation
% of Total
Long-Term
Investments
Information Technology
55.5%
Communication Services
40.7
Consumer Discretionary
2.8
Health Care
1.0
Total
100.0%
Top Ten Holdings
% of Total
Long-Term
Investments
Xiaomi Corp., Class B
3.5%
Micron Technology, Inc.
3.4
Intel Corp.
3.4
Activision Blizzard, Inc.
3.4
Synopsys, Inc.
3.3
Adobe, Inc.
3.2
Zoom Video Communications, Inc., Class A
3.2
Amphenol Corp., Class A
3.2
NetEase, Inc.
3.1
Meta Platforms, Inc., Class A
3.1
Total
32.8%
Performance figures assume reinvestment of
all distributions and do not reflect the
deduction of taxes that a shareholder would
pay on Fund distributions or the redemption
or sale of Fund shares. An index is a statistical
composite that tracks a specified financial
market or sector. Unlike the Fund, the indices
do not actually hold a portfolio of securities
and therefore do not incur the expenses
incurred by the Fund. These expenses
negatively impact the performance of the
Fund. The Fund’s past performance does not
predict future performance.
Frequency Distribution of Discounts and Premiums
Information showing the number of days the market price of the Fund’s shares was greater (at a premium) and less (at a discount) than the Fund’s net asset value for the most recently completed year, and the most recently completed calendar quarters since that year (or life of the Fund, if shorter) is available at https://www.ftportfolios.com/Retail/etf/home.aspx.
Page 7

Fund Performance Overview (Unaudited) (Continued)
First Trust Bloomberg Emerging Market Democracies ETF (EMDM)
The First Trust Bloomberg Emerging Market Democracies ETF (the “Fund”) seeks investment results that correspond generally to the price and yield (before the Fund’s fees and expenses) of an equity index called the Bloomberg Emerging Market Democracies Index (the “Index”). The shares of the Fund are listed and trade on the NYSE Arca, Inc. under the ticker symbol “EMDM.” The Fund will normally invest at least 80% of its net assets (plus any borrowings for investment purposes) in the common stocks, depositary receipts, preferred shares, real estate investment trusts (“REITs”) and other securities that comprise the Index. The Index is owned and was developed and sponsored by Bloomberg Index Services Limited (the “Index Provider”). The Index Provider is not affiliated with the Fund, the Fund’s investment advisor or the Fund’s distributor. According to the Index Provider, the Index is constructed to track the performance of companies within emerging market countries, as determined by the Index Provider, that meet minimum political rights and civil liberties standards to qualify as Electoral Democracies according to Freedom House, a non-profit, majority U.S. government funded organization in Washington D.C. that conducts research and advocacy on democracy, political freedom, and human rights. According to the Index Provider, to be eligible for inclusion in the Index, a security must be a constituent of the Bloomberg Emerging Markets Large & Mid Cap universe, meet the market capitalization and liquidity standards of the Index and belong to a country that is classified as an Electoral Democracy according to data from Freedom House.
Performance
 
Cumulative
Total Returns
 
Inception
(3/2/23)
to 9/30/23
Fund Performance
 
NAV
0.83%
Market Price
1.18%
Index Performance
 
Bloomberg Emerging Market Democracies Index
2.11%
MSCI Emerging Markets Index
-0.75%
(See Notes to Fund Performance Overview on page 10.)
Performance Review
The Fund generated a NAV return of 0.83% from the Fund’s inception on March 2, 2023 through September 30, 2023. During the same period, the MSCI Emerging Markets Index (the “Benchmark”) generated a return of -0.75%. During the same period, the Fund gave a nearly equal allocation to investments in six countries:South Korea, 15.5%; Mexico, 15.5%; Brazil, 15.3%; India, 14.9%; Taiwan, 14.6%; and South Africa, 13.1%. The greatest contributor to the Fund’s return were investments in Brazil, which contributed 2.5% to the Fund’s overall return. The greatest drag on the Fund’s performance came from investments in Chile. The Fund invested in only two Chilean securities, but their combined contribution to the Fund’s return was -1.4%. The Fund’s currency exposure had a -1.4% impact on performance during the period covered by this report.

“Bloomberg®” and Bloomberg Emerging Market Democracies Index licensed herein (the “Indices”) are service marks of Bloomberg Finance L.P. and its affiliates, including Bloomberg Index Services Limited (“BISL”), the administrator of the Indices (collectively, “Bloomberg”) and have been licensed for use for certain purposes by First Trust Advisors L.P. (the “Licensee”). Bloomberg is not affiliated with the Licensee, and Bloomberg does not approve, endorse, review, or recommend the financial products referenced herein (the “Financial Products”). Bloomberg does not guarantee the timeliness, accurateness, or completeness of any data or information relating to the Indices or the Financial Products.
Page 8

Fund Performance Overview (Unaudited) (Continued)
First Trust Bloomberg Emerging Market Democracies ETF (EMDM) (Continued)
Sector Allocation
% of Total
Long-Term
Investments
Financials
25.0%
Information Technology
22.8
Materials
13.8
Energy
8.6
Consumer Staples
7.8
Consumer Discretionary
6.7
Industrials
6.5
Communication Services
5.7
Utilities
2.3
Health Care
0.8
Total
100.0%
Top Ten Holdings
% of Total
Long-Term
Investments
Samsung Electronics Co., Ltd.
8.1%
Taiwan Semiconductor Manufacturing Co.,
Ltd.
7.9
Naspers Ltd., Class N
4.1
Petroleo Brasileiro S.A.
3.8
Grupo Mexico S.A.B. de C.V.
3.6
Vale S.A.
3.2
ORLEN S.A.
3.1
Grupo Financiero Banorte S.A.B. de C.V.,
Class O
2.9
Fomento Economico Mexicano S.A.B. de C.V.
2.9
HDFC Bank Ltd.
2.6
Total
42.2%
Performance figures assume reinvestment of
all distributions and do not reflect the
deduction of taxes that a shareholder would
pay on Fund distributions or the redemption
or sale of Fund shares. An index is a statistical
composite that tracks a specified financial
market or sector. Unlike the Fund, the indices
do not actually hold a portfolio of securities
and therefore do not incur the expenses
incurred by the Fund. These expenses
negatively impact the performance of the
Fund. The Fund’s past performance does not
predict future performance.
Frequency Distribution of Discounts and Premiums
Information showing the number of days the market price of the Fund’s shares was greater (at a premium) and less (at a discount) than the Fund’s net asset value for the most recently completed year, and the most recently completed calendar quarters since that year (or life of the Fund, if shorter) is available at https://www.ftportfolios.com/Retail/etf/home.aspx.
Page 9

Notes to Fund Performance Overview (Unaudited)
Total returns for the periods since inception are calculated from the inception date of each Fund. “Average Annual Total Returns” represent the average annual change in value of an investment over the periods indicated. “Cumulative Total Returns” represent the total change in value of an investment over the periods indicated.
Each Fund’s per share net asset value (“NAV”) is the value of one share of the Fund and is computed by dividing the value of all assets of the Fund (including accrued interest and dividends), less all liabilities (including accrued expenses and dividends declared but unpaid), by the total number of outstanding shares. The price used to calculate market return (“Market Price”) is determined by using the midpoint of the national best bid and offer price (“NBBO”) as of the time that the Fund’s NAV is calculated. Under the Securities and Exchange Commission’s rules, the NBBO consists of the highest displayed buy and lowest sell prices among the various exchanges trading the Fund at the time the Fund’s NAV is calculated. Since shares of each Fund did not trade in the secondary market until after the Fund’s inception, for the period from inception to the first day of secondary market trading in shares of the Fund, the NAV of each Fund is used as a proxy for the secondary market trading price to calculate market returns. NAV and market returns assume that all distributions have been reinvested in each Fund at NAV and Market Price, respectively.
An index is a statistical composite that tracks a specified financial market or sector. Unlike each Fund, the indices do not actually hold a portfolio of securities and therefore do not incur the expenses incurred by each Fund. These expenses negatively impact the performance of each Fund. Also, market returns do not include brokerage commissions that may be payable on secondary market transactions. If brokerage commissions were included, market returns would be lower. The total returns presented reflect the reinvestment of dividends on securities in the indices. The returns presented do not reflect the deduction of taxes that a shareholder would pay on Fund distributions or the redemption or sale of Fund shares. The investment return and principal value of shares of each Fund will vary with changes in market conditions. Shares of each Fund may be worth more or less than their original cost when they are redeemed or sold in the market. Each Fund’s past performance is no guarantee of future performance. 
Page 10

First Trust Exchange-Traded Fund II
Understanding Your Fund Expenses
September 30, 2023 (Unaudited)
As a shareholder of First Trust Nasdaq Lux Digital Health Solutions ETF, First Trust Indxx Metaverse ETF, or First Trust Bloomberg Emerging Market Democracies ETF (each a “Fund” and collectively, the “Funds”), you incur two types of costs: (1) transaction costs; and (2) ongoing costs, including management fees, distribution and/or service (12b-1) fees, if any, and other Fund expenses. This Example is intended to help you understand your ongoing costs (in U.S. dollars) of investing in the Funds and to compare these costs with the ongoing costs of investing in other funds.
The Example is based on an investment of $1,000 invested at the beginning of the period and held through the six-month period ended September 30, 2023.
Actual Expenses
The first line in the following table provides information about actual account values and actual expenses. You may use the information in this line, together with the amount you invested, to estimate the expenses that you paid over the period. Simply divide your account value by $1,000 (for example, an $8,600 account value divided by $1,000 = 8.6), then multiply the result by the number in the first line under the heading entitled “Expenses Paid During the Six-Month Period” to estimate the expenses you paid on your account during this six-month period.
Hypothetical Example for Comparison Purposes
The second line in the following table provides information about hypothetical account values and hypothetical expenses based on each Fund’s actual expense ratio and an assumed rate of return of 5% per year before expenses, which is not each Fund’s actual return. The hypothetical account values and expenses may not be used to estimate the actual ending account balance or expenses you paid for the period. You may use this information to compare the ongoing costs of investing in the Funds and other funds. To do so, compare this 5% hypothetical example with the 5% hypothetical examples that appear in the shareholder reports of the other funds.
Please note that the expenses shown in the table are meant to highlight your ongoing costs only and do not reflect any transactional costs such as brokerage commissions. Therefore, the second line in the table is useful in comparing ongoing costs only, and will not help you determine the relative total costs of owning different funds. In addition, if these transactional costs were included, your costs would have been higher.
 
Beginning
Account Value
April 1, 2023
Ending
Account Value
September 30, 2023
Annualized
Expense Ratio
Based on the
Six-Month
Period
Expenses Paid
During the
Six-Month
Period (a)
First Trust Nasdaq Lux Digital Health Solutions ETF (EKG)
Actual
$1,000.00
$819.20
0.65%
$2.96
Hypothetical (5% return before expenses)
$1,000.00
$1,021.81
0.65%
$3.29
First Trust Indxx Metaverse ETF (ARVR)
Actual
$1,000.00
$990.60
0.70%
$3.49
Hypothetical (5% return before expenses)
$1,000.00
$1,021.56
0.70%
$3.55
First Trust Bloomberg Emerging Market Democracies ETF (EMDM)
Actual
$1,000.00
$994.20
0.75%
$3.75
Hypothetical (5% return before expenses)
$1,000.00
$1,021.31
0.75%
$3.80
(a)
Expenses are equal to the annualized expense ratio as indicated in the table multiplied by the average account value over the period
(April 1, 2023 through September 30, 2023), multiplied by 183/365 (to reflect the six-month period).
Page 11

First Trust Nasdaq Lux Digital Health Solutions ETF (EKG)
Portfolio of Investments
September 30, 2023 
Shares
Description
Value
COMMON STOCKS — 100.0%
Biotechnology — 8.7%
385
Exact Sciences Corp. (a)
$26,265
283
Myriad Genetics, Inc. (a)
4,539
472
Natera, Inc. (a)
20,886
187
Twist Bioscience Corp. (a)
3,788
245
Veracyte, Inc. (a)
5,471
 
60,949
Health Care Equipment &
Supplies — 52.2%
174
Align Technology, Inc. (a)
53,126
356
Alphatec Holdings, Inc. (a)
4,617
195
Axonics, Inc. (a)
10,943
639
Dexcom, Inc. (a)
59,619
95
Establishment Labs Holdings,
Inc. (a)
4,662
444
Globus Medical, Inc.,
Class A (a)
22,045
431
Hologic, Inc. (a)
29,911
121
Inspire Medical Systems, Inc. (a)
24,011
168
Insulet Corp. (a)
26,794
206
Intuitive Surgical, Inc. (a)
60,212
92
iRhythm Technologies, Inc. (a)
8,672
139
Masimo Corp. (a)
12,188
162
QuidelOrtho Corp. (a)
11,832
202
ResMed, Inc.
29,870
193
Tandem Diabetes Care, Inc. (a)
4,009
99
TransMedics Group, Inc. (a)
5,420
 
367,931
Health Care Providers &
Services — 6.5%
227
Accolade, Inc. (a)
2,402
76
Fulgent Genetics, Inc. (a)
2,032
416
Guardant Health, Inc. (a)
12,330
675
Hims & Hers Health, Inc. (a)
4,246
446
NeoGenomics, Inc. (a)
5,486
377
Privia Health Group, Inc. (a)
8,671
310
Progyny, Inc. (a)
10,546
 
45,713
Health Care Technology —
12.9%
449
Doximity, Inc., Class A (a)
9,528
218
Health Catalyst, Inc. (a)
2,206
183
Schrodinger, Inc. (a)
5,174
597
Teladoc Health, Inc. (a)
11,098
309
Veeva Systems, Inc., Class A (a)
62,866
 
90,872
Life Sciences Tools & Services
— 19.7%
362
10X Genomics, Inc., Class A (a)
14,933
512
Adaptive Biotechnologies
Corp. (a)
2,790
Shares
Description
Value
 
Life Sciences Tools & Services
(Continued)
393
Cytek Biosciences, Inc. (a)
$2,169
195
Illumina, Inc. (a)
26,770
290
IQVIA Holdings, Inc. (a)
57,057
784
Pacific Biosciences of
California, Inc. (a)
6,546
709
QIAGEN N.V. (a)
28,715
 
138,980
Total Common Stocks
704,445
(Cost $937,261)
MONEY MARKET FUNDS — 0.1%
724
Morgan Stanley Institutional
Liquidity Funds - Treasury
Portfolio - Institutional Class -
5.20% (b)
724
(Cost $724)
Total Investments — 100.1%
705,169
(Cost $937,985)
Net Other Assets and
Liabilities — (0.1)%
(401
)
Net Assets — 100.0%
$704,768
(a)
Non-income producing security.
(b)
Rate shown reflects yield as of September 30, 2023.

Valuation Inputs
A summary of the inputs used to value the Fund’s investments as of September 30, 2023 is as follows (see Note 2A - Portfolio Valuation in the Notes to Financial Statements):
 
Total
Value at
9/30/2023
Level 1
Quoted
Prices
Level 2
Significant
Observable
Inputs
Level 3
Significant
Unobservable
Inputs
Common Stocks*
$704,445
$704,445
$
$
Money Market Funds
724
724
Total Investments
$705,169
$705,169
$
$
*
See Portfolio of Investments for industry breakout.
See Notes to Financial Statements
Page 12

First Trust Indxx Metaverse ETF (ARVR)
Portfolio of Investments
September 30, 2023 
Shares
Description
Value
COMMON STOCKS (a) — 99.8%
Electronic Equipment,
Instruments & Components
— 6.5%
550
Amphenol Corp., Class A
$46,194
32,501
AUO Corp. (TWD)
16,512
4,602
Sunny Optical Technology
Group Co., Ltd. (HKD)
32,142
 
94,848
Entertainment — 32.4%
526
Activision Blizzard, Inc.
49,249
516
Capcom Co., Ltd. (JPY)
18,621
1,530
DeNA Co., Ltd. (JPY)
15,405
345
Electronic Arts, Inc.
41,538
982
GungHo Online Entertainment,
Inc. (JPY)
15,534
1,136
Koei Tecmo Holdings Co., Ltd.
(JPY)
16,181
1,062
Mixi, Inc. (JPY)
16,874
2,242
NetEase, Inc. (HKD)
45,660
105
Netflix, Inc. (b)
39,648
530
Netmarble Corp.
(KRW) (b) (c) (d)
16,535
2,312
Nexon Co., Ltd. (JPY)
41,422
1,040
Nintendo Co., Ltd. (JPY)
43,419
1,064
ROBLOX Corp., Class A (b)
30,813
410
Square Enix Holdings Co., Ltd.
(JPY)
14,081
316
Take-Two Interactive Software,
Inc. (b)
44,363
682
Ubisoft Entertainment S.A.
(EUR) (b)
22,211
 
471,554
Health Care Technology —
1.0%
780
Teladoc Health, Inc. (b)
14,500
Household Durables — 2.8%
494
Sony Group Corp. (JPY)
40,520
Interactive Media & Services
— 8.2%
150
Meta Platforms, Inc., Class A (b)
45,032
3,488
Snap, Inc., Class A (b)
31,078
1,100
Tencent Holdings Ltd. (HKD)
43,006
 
119,116
IT Services — 1.2%
899
Keywords Studios PLC (GBP)
16,975
Semiconductors &
Semiconductor Equipment
— 26.5%
407
Advanced Micro Devices,
Inc. (b)
41,848
1,391
Intel Corp.
49,450
Shares
Description
Value
 
Semiconductors &
Semiconductor Equipment
(Continued)
510
Microchip Technology, Inc.
$39,805
730
Micron Technology, Inc.
49,662
102
NVIDIA Corp.
44,369
383
QUALCOMM, Inc.
42,536
893
STMicroelectronics N.V. (EUR)
38,750
446
Taiwan Semiconductor
Manufacturing Co., Ltd., ADR
38,757
257
Texas Instruments, Inc.
40,866
 
386,043
Software — 14.8%
91
Adobe, Inc. (b)
46,401
138
Microsoft Corp.
43,574
105
Synopsys, Inc. (b)
48,192
1,006
Unity Software, Inc. (b)
31,578
661
Zoom Video Communications,
Inc., Class A (b)
46,230
 
215,975
Technology Hardware, Storage
& Peripherals — 6.4%
247
Apple, Inc.
42,289
32,024
Xiaomi Corp., Class B
(HKD) (b) (c) (d)
50,457
 
92,746
Total Investments — 99.8%
1,452,277
(Cost $1,522,276)
Net Other Assets and
Liabilities — 0.2%
2,619
Net Assets — 100.0%
$1,454,896
(a)
Securities are issued in U.S. dollars unless otherwise
indicated in the security description.
(b)
Non-income producing security.
(c)
This security is exempt from registration upon resale under
Rule 144A of the Securities Act of 1933, as amended (the
“1933 Act”) and may be resold in transactions exempt from
registration, normally to qualified institutional buyers. This
security is not restricted on the foreign exchange where it
trades freely without any additional registration. As such, it
does not require the additional disclosure required of
restricted securities.
(d)
This security may be resold to qualified foreign investors and
foreign institutional buyers under Regulation S of the 1933
Act.
See Notes to Financial Statements
Page 13

First Trust Indxx Metaverse ETF (ARVR)
Portfolio of Investments (Continued)
September 30, 2023 
Abbreviations throughout the Portfolio of Investments:
ADR
American Depositary Receipt
EUR
Euro
GBP
British Pound Sterling
HKD
Hong Kong Dollar
JPY
Japanese Yen
KRW
South Korean Won
TWD
New Taiwan Dollar
Currency Exposure Diversification
% of Total
Investments
United States Dollar
65.3%
Japanese Yen
15.3
Hong Kong Dollar
11.8
Euro
4.2
British Pound Sterling
1.2
South Korean Won
1.1
New Taiwan Dollar
1.1
Total
100.0%
Country Allocation
% of Net
Assets
United States
62.5%
Japan
15.2
Cayman Islands
11.8
Taiwan
3.8
Netherlands
2.7
France
1.5
United Kingdom
1.2
South Korea
1.1
Total Investments
99.8
Net Other Assets and Liabilities
0.2
Total
100.0%
Portfolio securities are categorized based upon their country of
incorporation, which can be different from the country
categorization of the Fund’s underlying index.

Valuation Inputs
A summary of the inputs used to value the Fund’s investments as of September 30, 2023 is as follows (see Note 2A - Portfolio Valuation in the Notes to Financial Statements):
 
Total
Value at
9/30/2023
Level 1
Quoted
Prices
Level 2
Significant
Observable
Inputs
Level 3
Significant
Unobservable
Inputs
Common Stocks*
$1,452,277
$1,452,277
$
$
*
See Portfolio of Investments for industry breakout.
See Notes to Financial Statements
Page 14

First Trust Bloomberg Emerging Market Democracies ETF (EMDM)
Portfolio of Investments
September 30, 2023 
Shares
Description
Value
COMMON STOCKS (a) — 99.8%
Brazil — 16.8%
8,196
Ambev S.A.
$21,376
10,999
B3 S.A. - Brasil Bolsa Balcao
26,893
12,194
Banco Bradesco S.A. (Preference
Shares)
34,691
5,176
Banco BTG Pactual S.A.
31,994
2,643
Banco do Brasil S.A.
24,808
7,361
Banco Santander Brasil S.A.
38,148
9,684
Itau Unibanco Holding S.A.
(Preference Shares)
52,422
11,212
Itausa S.A. (Preference Shares)
20,186
1,535
Localiza Rent a Car S.A.
17,883
16,240
Petroleo Brasileiro S.A.
(Preference Shares)
111,916
7,040
Vale S.A.
94,650
2,804
WEG S.A.
20,233
 
495,200
Cayman Islands — 0.2%
918
Chailease Holding Co., Ltd.
5,147
Chile — 2.4%
1,185
Sociedad Quimica y Minera de
Chile S.A., Class B
(Preference Shares)
70,477
Czech Republic — 1.9%
1,299
CEZ AS
55,174
India — 16.5%
400
Asian Paints Ltd.
15,226
141
Avenue Supermarts
Ltd. (b) (c) (d)
6,241
1,606
Axis Bank Ltd.
20,050
150
Bajaj Finance Ltd.
14,109
323
Bajaj Finserv Ltd.
5,991
1,269
Bharti Airtel Ltd.
14,157
580
HCL Technologies Ltd.
8,625
4,238
HDFC Bank Ltd.
77,895
469
Hindustan Unilever Ltd.
13,925
3,856
ICICI Bank Ltd.
44,201
417
IndusInd Bank Ltd.
7,175
1,940
Infosys Ltd.
33,535
4,261
ITC Ltd.
22,803
760
Kotak Mahindra Bank Ltd.
15,885
593
Larsen & Toubro Ltd.
21,591
522
Mahindra & Mahindra Ltd.
9,770
74
Maruti Suzuki India Ltd.
9,455
20
Nestle India Ltd.
5,421
2,491
NTPC Ltd.
7,366
2,410
Power Grid Corp. of India Ltd.
5,797
1,775
Reliance Industries Ltd.
50,124
16
Shree Cement Ltd.
4,907
1,875
State Bank of India
13,515
Shares
Description
Value
 
India (Continued)
583
Sun Pharmaceutical Industries
Ltd.
$8,134
520
Tata Consultancy Services Ltd.
22,096
1,063
Tata Motors Ltd.
8,067
4,311
Tata Steel Ltd.
6,692
219
Titan Co., Ltd.
8,304
65
UltraTech Cement Ltd.
6,461
 
487,518
Mexico — 15.1%
75,984
America Movil S.A.B. de C.V.,
Series B
65,792
53,813
Cemex S.A.B. de C.V.,
Series CPO (c)
35,109
7,683
Fomento Economico Mexicano
S.A.B. de C.V., Series UBD
83,908
10,251
Grupo Financiero Banorte
S.A.B. de C.V., Class O
85,943
22,370
Grupo Mexico S.A.B. de C.V.,
Series B
105,884
18,306
Wal-Mart de Mexico S.A.B. de
C.V.
68,907
 
445,543
Philippines — 1.5%
2,979
SM Investments Corp.
44,414
Poland — 3.0%
6,702
ORLEN S.A.
90,052
South Africa — 12.0%
21,965
FirstRand Ltd.
74,084
4,553
Gold Fields Ltd.
49,371
8,105
MTN Group Ltd.
48,308
761
Naspers Ltd., Class N
121,605
6,210
Standard Bank Group Ltd.
60,258
 
353,626
South Korea — 15.1%
82
Celltrion, Inc.
8,459
41
Ecopro BM Co., Ltd.
7,687
223
Hana Financial Group, Inc.
7,015
46
Hyundai Mobis Co., Ltd.
8,199
100
Hyundai Motor Co.
14,162
235
Kakao Corp.
7,654
269
KB Financial Group, Inc.
11,024
190
Kia Corp.
11,461
36
LG Chem Ltd.
13,246
83
LG Electronics, Inc.
6,206
20
LG Energy Solution Ltd. (c)
7,063
111
NAVER Corp.
16,575
51
POSCO Holdings, Inc.
20,220
15
Samsung Biologics Co.,
Ltd. (b) (c) (d)
7,570
4,699
Samsung Electronics Co., Ltd.
238,189
40
Samsung SDI Co., Ltd.
15,177
See Notes to Financial Statements
Page 15

First Trust Bloomberg Emerging Market Democracies ETF (EMDM)
Portfolio of Investments (Continued)
September 30, 2023 
Shares
Description
Value
COMMON STOCKS (a) (Continued)
South Korea (Continued)
380
Shinhan Financial Group Co.,
Ltd.
$10,025
415
SK Hynix, Inc.
35,275
 
445,207
Taiwan — 14.1%
2,204
ASE Technology Holding Co.,
Ltd.
7,476
5,534
Cathay Financial Holding Co.,
Ltd.
7,637
6,962
China Steel Corp.
5,446
3,108
Chunghwa Telecom Co., Ltd.
11,169
11,143
CTBC Financial Holding Co.,
Ltd.
8,457